A study on the use of the Osstell apparatus to evaluate pedicle screw stability: An in-vitro study using micro-CT.
A study on the use of the Osstell apparatus to evaluate pedicle screw stability: An in-vitro study using micro-CT.
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DOI：
10.1371/journal.pone.0199362
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Nagura T
中科院分区：
文献类型：
--
作者：
Nakashima D;Ishii K;Matsumoto M;Nakamura M;Nagura T
由于拔出力和插入扭矩的侵袭性，在术中评价椎弓根螺钉的稳定性时，通常不使用它们。另一方面，共振频率分析是一种非侵入性和可重复的技术，已被临床应用于口腔医学以评估种植体的稳定性，例如通过Osstell仪器。本研究探讨了在脊柱外科领域使用Osstell装置测量种植体稳定性商(ISQ)的特点。使用模拟人体骨骼的生物力学测试材料，为评估各种固定强度指标提供比较平台，包括拔出力、插入扭矩和ISQ值。为了测量拔出力并重复椎弓根螺钉的插入和取出，人工松动椎弓根螺钉，并观察其效果。取出椎弓根螺钉后，在显微CT图像上对松动程度进行量化。在3种固定强度指标的比较中，ISQ值与拔出力(R2=0.339 p<；0.0001)和插入扭矩(R2=0.337 p<；0.0001)的相关性均低于拔出力与插入扭矩(R2=0.918 p&t；0.0001)的相关性。在显微CT研究中，由于反复插入和取出椎弓根螺钉，内螺纹的材料体积在其完整性被破坏后消失。内螺纹的材料完整性破坏仅降低了拔出力和插入扭矩，但不影响ISQ值。只有当内螺纹的材料体积消失时，ISQ值才会下降，这可能是因为ISQ值反映了螺钉垂直方向上的阻力，而不同于反映轴向载荷的传统固定强度测量，如拔出力和插入扭矩。
Pull-out force and insertion torque have not been generally used as intraoperative measures for the evaluation of pedicle screw stability because of their invasiveness. On the other hand, resonance frequency analysis is a non-invasive and repeatable technique that has been clinically used in dentistry to evaluate implant stability e.g. by the Osstell apparatus. In this study, the characteristics of the implant stability quotient (ISQ) value obtained by the Osstell apparatus in the field of spinal surgery were investigated. Biomechanical test materials simulating human bone were used to provide a comparative platform for evaluating each fixation strength measure, including pull-out force, insertion torque, and the ISQ value. To perform pull-out force measurement and to repeat pedicle screw insertion and removal, loosening was artificially created, and its effect was investigated. The grade of loosening was quantified on a micro-CT image after pedicle screw removal. In the comparison of the 3 fixation strength measures, the correlations of the ISQ value with the pull-out force (R2 = 0.339 p <0.0001) and the insertion torque (R2 = 0.337 p <0.0001) were lower than the correlation between pull-out force and insertion torque (R2 = 0.918 p <0.0001). On a micro-CT study, the material volume of the internal threads disappeared after destruction of its integrity due to repeated pedicle screw insertion and removal. Material integrity destruction of the internal threads decreased only the pull-out force and the insertion torque, but it did not affect the ISQ value. The ISQ value only decreased when the material volume of the internal threads disappeared, probably because the ISQ value reflects the resistance against a force in the perpendicular direction of the screw, unlike the conventional measures of fixation strength, such as pull-out force and insertion torque, which reflect axial load.
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DOI：
10.1097/00002517-199407020-00007
发表时间：
1994-04-01
期刊：
JOURNAL OF SPINAL DISORDERS
影响因子：
--
作者：
DAFTARI, TK;HORTON, WC;HUTTON, WC
通讯作者：
HUTTON, WC
影响因子：
2.2
作者：
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通讯作者：
Dzan, Ladislav
DOI：
10.1177/0954411914561485
发表时间：
2015-01-01
影响因子：
1.8
作者：
Henys, Petr;Capek, Lukas;Prochazka, Egon
通讯作者：
Prochazka, Egon
影响因子：
3
作者：
HALVORSON, TL;KELLEY, LA;COOK, SD
通讯作者：
COOK, SD
影响因子：
0.8
作者：
Cakir, Ertugrul;Eyuboglu, Eylem Eren;Baykal, Suleyman
通讯作者：
Baykal, Suleyman